POS0804-HPR INVESTIGATION OF THE VALIDITY AND RELIABILITY OF THE STEP UP AND DOWN TEST IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY SURGERY
Authors: S. Tarkan, B. Unver, V. Karatosun
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Stair climbing has been showed as the first changing activity in patients with knee osteoarthritis (KOA) [1]. Stair climbing and step tests of patients with KOA are used as measurement tools to determine the functional level of patients and to determine the effectiveness of treatment. Patients with KOA undergoing total knee arthroplasty (TKA) show asymmetrical patterns and slower climbing stairs when the affected limb is compared to the healthy limb [2]. Therefore, unilateral evaluation of the extremity undergoing TKA is important. There are many tests that evaluate stair climbing function in patients with TKA. However, the Step Up and Down (StUD) test, which was previously found to be valid and reliable in knee osteoarthritis, is a 15-second test that can evaluate the affected limb unilaterally, requires only one stair, and is similar to the daily living activities of the patients [3]. For this reason, it would be useful to use it as a criterion in the evaluation of the physical functions of individuals with TKA. However, there is no study on the validity and reliability of the StUD test in patients with TKA. <h3>Objectives</h3> The aim of the study is to measure the validity and reliability of the StUD test in patients with TKA. <h3>Methods</h3> Forty patients (Mean age; 6,87 ± 8,01) with primary TKA included in this study. The test-retest reliability of the StUD test was measured with a 1-hour interval to prevent fatigue. Validity was assessed by testing predefined hypotheses. Therefore, the 30s Chair Stand Test (30sCS), the Hospital for Special Surgery score (HSS) and Short Form-12 Quality Life Questionnaire (SF-12) were used as comparator instruments. <h3>Results</h3> The StUD test showed good correlation with 30sCS test (r=0,706, p&lt;0,001), moderate to low correlation with HSS score (r=0,4, p&lt;0,001), moderate correlation with SF12 score (r=0,508, p&lt;0,001). Test-retest reliability was excellent (ICC= 0,93, %95 CI= 0,87-0,96). Standard error of measurement and smallest real difference at the 95% confidence level for StUD test were respectively 0,34 and 0,94. There was no significant difference in the mean VAS scores measured after the tests or between the first and the second trials (p &gt;.05) <h3>Conclusion</h3> According to the results of our study the StUD test excellent reliability, good validity and high sensitivity in patients with TKA. Additionally, there was no significant increase in pain levels at the end of the test. This result suggests that StUD test can be used the safely without increasing pain levels, and this test can also be tolerated by patients with TKA. The SRD<sub>95</sub> of StUD test was 0,94. According this, it can be interpreted that the STUD test can be used reliably to monitor small changes in patients' function. <h3>References</h3> [1]Gonçalves GH, Selistre LFA, Petrella M, Mattiello SM. Kinematic alterations of the lower limbs and pelvis during an ascending stairs task are associated with the degree of knee osteoarthritis severity. Knee. 2017;24(2):295-304. [2]Pozzi F, Snyder-Mackler L, Zeni J Jr. Relationship between biomechanical asymmetries during a step up and over task and stair climbing after total knee arthroplasty. <i>Clin Biomech</i>. 2015;30(1):78-85. [3]Almeida GPL, Monteiro IO, Dantas RGO, Tavares MLA, Lima POP. Reliability, validity and responsiveness of the Step Up and Down (StUD) test for individuals with symptomatic knee osteoarthritis. <i>Musculoskelet Sci Pract</i>. 2021; 56:102454. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.